Provider Demographics
NPI:1437863636
Name:NEW U PHYSICAL THERAPY PROFESSIONAL ASSOCIATION
Entity type:Organization
Organization Name:NEW U PHYSICAL THERAPY PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:POLONSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-502-5271
Mailing Address - Street 1:20 CRYSTAL CT
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8881
Mailing Address - Country:US
Mailing Address - Phone:718-502-5871
Mailing Address - Fax:
Practice Address - Street 1:154 STELTON RD
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-2667
Practice Address - Country:US
Practice Address - Phone:718-502-5271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty